Thalamic pain alleviated by stellate ganglion block

Liao, Chenlong; Yang, Min Jae; Liu, Pengfei; Zhong, Wenxiang; Zhang, Wenchuan

doi:10.1097/md.0000000000006058

Cited by 15 publications

(18 citation statements)

References 8 publications

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“…8 A case report published 3 years earlier claimed that stellate ganglion block is effective for CPSP. 12 Ultrasound guidance could improve the accuracy of local anesthetic injection into target site. 15,16 The use of ultrasound-guided in the index case it apparently helpful in achieving therapeutic action.…”

Section: Discussionmentioning

confidence: 99%

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<p>Ultrasound-Guided Stellate Ganglion Block for Central Post-Stroke Pain: A Case Report and Review</p>

Liu¹,

Qing²,

Tang³

et al. 2020

JPR

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Background: Central post-stroke pain (CPSP) is refractory to pharmacotherapy (eg, NSAIDs, opioids, antidepressants, and anticonvulsants), and may require transcranial or deep brain stimulation. Case Presentation: A 67-year-old woman presented with severe paroxysmal cramp-like pain on the right side, including the head and both upper and lower extremities. The pain started 5 years earlier, was initially mild and occasional, but gradually intensified to an unbearable degree with an average of 10-15 daily episodes, each lasting for 5-10 mins. The patient disclosed "hemorrhagic stroke" 10 years ago that resulted in hemiplegia on the right side. CT examination verified the lesion. The patient received daily injection of 2-mL 2% lidocaine under ultrasound guidance to block the stellate ganglion. Pain subsided rapidly in both intensity and frequency. On the seventh day, the patient no longer had pain episodes. At the last follow-up, 9 months later, the patient was free from pain. Conclusion: Ultrasound-guided stellate ganglion block is a viable alternative for CPSP that is refractory to pharmacotherapy.

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Section: Discussionmentioning

confidence: 99%

“…[8][9][10] Stellate ganglion block is a method to treat reflex sympathetic dystrophy, 11 and was reported to be effective for thalamic pain in a case report in 2007. 12 We now report a case of successful treatment of cramp-like pain after thalamic hemorrhage using ultrasound-guided stellate ganglion block.…”

Section: Introductionmentioning

confidence: 93%

<p>Ultrasound-Guided Stellate Ganglion Block for Central Post-Stroke Pain: A Case Report and Review</p>

Liu¹,

Qing²,

Tang³

et al. 2020

JPR

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“…We felt that this intervention was reasonable to offer in this scenario as the stellate ganglion block has been successfully utilized to treat a wide range of conditions including CRPS, upper extremity pain, and even CPSP in one case report [13].…”

Section: Stellate Ganglion Block Procedures and Resultsmentioning

confidence: 99%

Treatment of Post-Stroke Shoulder Pain of Multi-Factorial Etiology

Stephen¹,

Varun²,

Mina³

et al. 2020

J Clin Anesth Pain Manag

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Case Reportprevalence of 25-50% in stroke patients [4]. Its development is likely multifactorial, involving glenohumeral subluxation, impingement, rotator cuff tears, bicipital tendinitis, and CRPS [4]. Glenohumeral subluxation can occur as a result of weakness in the muscles that surround and provide stability to the shoulder joint. The joint is most vulnerable to subluxation in the period immediately after stroke, when muscle tone in the upper extremity is flaccid [6]. Subluxation itself can result in further complications, including CRPS and secondary brachial plexus injury.The estimated incidence of CRPS after stroke is between 2 and 49% [7,8]. CRPS is characterized by pain, edema, vasomotor abnormalities, and patchy demineralization of bone in an extremity, and is divided into two types based on the absence (Type I) or presence (Type II) of a definable nerve lesion. The majority of stroke patients with CRPS are diagnosed as Type I, however micro-trauma to nerves may in fact explain their are CPSP and Complex Regional Pain Syndrome (CRPS), and CPSP and shoulder pain [4].

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“…Lastly, stellate ganglion block has been reported to offer short-term relief of CPSP in a woman with refractory, lancinating, severe pain on the right side of her face and hand status post right basal ganglia/left thalamic stoke [34]. While initially thought to be a case of atypical tic douloureaux, this woman was found to have CPSP resistant to pharmacologic therapy [34]. The patient refused DBS given its invasive nature [34].…”

Section: Advances In Therapymentioning

confidence: 97%

“…While initially thought to be a case of atypical tic douloureaux, this woman was found to have CPSP resistant to pharmacologic therapy [34]. The patient refused DBS given its invasive nature [34]. Subsequently, the less invasive stellate ganglion block-a selective sympathetic block-was attempted because it had shown efficacy in ameliorating atypical facial conditions [34].…”

Section: Advances In Therapymentioning

confidence: 99%

Diagnosis, Treatment, and Management of Dejerine–Roussy Syndrome: a Comprehensive Review

Urits

Gress

Charipova

et al. 2020

Curr Pain Headache Rep

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Purpose of Review Post-stroke pain represents a complex condition with few standardized diagnostic criteria. As such, the array of symptoms is often difficult to categorize and diagnose. Central post-stroke pain (CPSP), also known as Dejerine-Roussy syndrome, presents as painful paresthesia in any part of the body that is usually coupled with sensory abnormalities. Recent Findings In patients who had experienced a cerebrovascular accident, CPSP typically affects the same areas of the body that are also impacted by the general motor and sensory deficits that result from stroke. Though it is generally debated, CPSP is thought to result from a lesion in any part of the central nervous system. Pain usually presents in the range of 3-6 months after the occurrence of stroke, manifesting contralaterally to the lesion, and most commonly involving the upper extremities. For the most accurate diagnosis of CPSP, a thorough history and clinical examination should be supplemented with imaging. Infarcted areas of the brain can be visualized using either CT or MRI. First-line treatment of CPSP is pharmacologic and consists of a three-drug regimen. Despite this, CPSP is often refractory to medical management producing only modest pain reduction in a limited subset of patients. Adverse effects associated with pharmacologic management of CPSP and frequent recalcitrance to treatment have driven alternative minimally invasive methods of pain control which include transcranial stimulation, deep brain stimulation, and neuromodulation. Summary The aim of this review is to provide a comprehensive update to recent advances in the understanding of the treatment and management of CPSP. KeywordsCentral post-stroke pain . Dejerine-Roussy . Central nervous system . Cerebrovascular accident This article is part of the Topical Collection on Other Pain

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Thalamic pain alleviated by stellate ganglion block

Cited by 15 publications

References 8 publications

<p>Ultrasound-Guided Stellate Ganglion Block for Central Post-Stroke Pain: A Case Report and Review</p>

<p>Ultrasound-Guided Stellate Ganglion Block for Central Post-Stroke Pain: A Case Report and Review</p>

Treatment of Post-Stroke Shoulder Pain of Multi-Factorial Etiology

Diagnosis, Treatment, and Management of Dejerine–Roussy Syndrome: a Comprehensive Review

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